PMID- 19216034
OWN - NLM
STAT- MEDLINE
DCOM- 20090818
LR  - 20090504
IS  - 1618-0631 (Electronic)
IS  - 0344-0338 (Linking)
VI  - 205
IP  - 6
DP  - 2009
TI  - Hyaline globules in paucicellular leiomyomas of the gastrointestinal tract are 
      distinct from skeinoid fibers and represent degenerating smooth muscle cells.
PG  - 417-22
LID - 10.1016/j.prp.2008.12.017 [doi]
AB  - Skeinoid fibers are globular, brightly eosinophilic periodic Schiff stain 
      (PAS)-positive extracellular collagen deposits commonly seen in gastrointestinal 
      stromal tumors (GIST) of the small bowel. However, smooth-surfaced hyaline 
      globules are occasionally encountered in leiomyomatous GI neoplasms and may be 
      mistaken for true skeinoid fibers. We investigated a total of 93 histologically 
      and immunohistochemically well-characterized true smooth muscle neoplasms of the 
      GI tract for the presence of hyaline globules. A variable number of PAS-positive 
      intracellular and interstitial hyaline globules were detected in all benign 
      paucicellular leiomyomas of the muscularis mucosae (n=72) and the muscularis 
      propria (n=14) irrespective of tumor size and site, but in none of 
      leiomyosarcomas (n=7) and cellular leiomyoma (n=1). In addition, similar findings 
      were rarely seen in the adjacent muscularis propria. Similar to surrounding tumor 
      cells, hyaline globules expressed desmin, alpha-SMA, and h-caldesmon, but were 
      negative for CD117 and CD34. Ultrastructural examination revealed altered 
      filamentous material in different stages of degeneration with variably condensed 
      matrix and occasional peripheral condensation suggestive of calcification. True 
      skeinoid fibers were not detected. The above findings are consistent with a 
      multistep degenerative phenomenon affecting individual smooth muscle cells in 
      paucicellular GI leiomyomas. Awareness of this finding would prevent 
      misinterpretation as GIST, particularly in small biopsies.
FAU - Agaimy, Abbas
AU  - Agaimy A
AD  - Institute of Pathology, University Hospital of Erlangen, Krankenhausstrasse 12, 
      91054 Erlagen, Germany. abbas.agaimy@uk-erlangen.de
FAU - Wunsch, Peter H
AU  - Wunsch PH
FAU - Hofstadter, Ferdinand
AU  - Hofstadter F
FAU - Schroeder, Josef
AU  - Schroeder J
LA  - eng
PT  - Journal Article
DEP - 20090211
PL  - Germany
TA  - Pathol Res Pract
JT  - Pathology, research and practice
JID - 7806109
SB  - IM
MH  - Diagnosis, Differential
MH  - Gastrointestinal Neoplasms/metabolism/*ultrastructure
MH  - Gastrointestinal Stromal Tumors/pathology
MH  - Humans
MH  - Hyalin/metabolism
MH  - Immunohistochemistry
MH  - Leiomyoma/metabolism/*ultrastructure
MH  - Microscopy, Electron, Transmission
MH  - Myocytes, Smooth Muscle/metabolism/*ultrastructure
EDAT- 2009/02/14 09:00
MHDA- 2009/08/19 09:00
CRDT- 2009/02/14 09:00
PHST- 2008/10/21 00:00 [received]
PHST- 2008/12/16 00:00 [accepted]
PHST- 2009/02/14 09:00 [entrez]
PHST- 2009/02/14 09:00 [pubmed]
PHST- 2009/08/19 09:00 [medline]
AID - S0344-0338(09)00010-7 [pii]
AID - 10.1016/j.prp.2008.12.017 [doi]
PST - ppublish
SO  - Pathol Res Pract. 2009;205(6):417-22. doi: 10.1016/j.prp.2008.12.017. Epub 2009 
      Feb 11.